Chapter 28Infections Flashcards
Exam 4 (Final)
Urinary Tract Infections (UTIs):
What are they the result of?
Urinary tract infections are the result of bacteria (often Escherichia coli) ascending into the urethra, bladder, and kidneys (pyelonephritis).
Urinary Tract Infections (UTIs):
What is the most common form of UTI? Where is it located?
Cystitis is the most common form of UTI and is limited to the bladder.
Urinary Tract Infections (UTIs)
What are symptoms of cystitis?
Symptoms of cystitis include:
urinary frequency,
urinary urgency,
a sensation of incomplete emptying,
pain with urination (dysuria),
and sometimes hematuria.
Urinary Tract Infections (UTIs):
What is a rare occurrence with cystitis?
Progression from cystitis to pyelonephritis is rare.
Urinary Tract Infections (UTIs):
What may be used to assess for UTIs?
What values are looked at?
Point-of-care urinalysis may be used to assess for UTIs. The values specific to UTI are leukocytes, nitrites, and blood.
Urinary Tract Infections (UTIs):
What must be done with UTIs?
A more definitive urine culture must be done in a laboratory.
Urinary Tract Infections: Treatments:
How do UTIs often resolve?
UTIs often resolve without treatment or may be treated with antibiotics.
Urinary Tract Infections: Treatments:
What is used to manage symptoms of a UTI?
Phenazopyridine is an over-the-counter urinary analgesic that can manage symptoms related to cystitis but it does not cure the UTI.
Urinary Tract Infections: Treatments
What should patient be taught about a specific UTI medication?
Patients should also be taught that phenazopyridine changes urine color to bright orange, which can be alarming.
Urinary Tract Infections: Treatments
If a UTI is treated with antibiotics, what should patients be taught?
If a UTI is treated with antibiotics, patients should be taught to finish their course of antibiotics even if they feel better.
Urinary Tract Infections: Treatments
How should patients be taking a specific UTI med?
Patients should be taught to take phenazopyridine for more than 2 days because it can mask UTI symptoms.
Urinary Tract Infections: Pyelonephritis
What is it?
Pyelonephritis is a UTI that has ascended into the kidneys.
Urinary Tract Infections: Pyelonephritis
What are symptoms?
Symptoms include fever, chills, flu-like symptoms, and back pain.
Urinary Tract Infections: Pyelonephritis
How is it diagnosed? Why?
Pyelonephritis is diagnosed by urine culture because it is important that the right antibiotic is prescribed to avoid long-term consequences.
Urinary Tract Infections: Pyelonephritis
What are long term consequences of this disease?
Long-term consequences include kidney failure, shock, multiple organ dysfunction, sepsis, and death.
Urinary Tract Infections: Pyelonephritis
What kind of medication is used to treat this?
Often treated with ciprofloxacin and levofloxacin.
Vaginosis: What is it?
Vaginosis refers to any abnormality of vaginal discharge.
Vaginosis:
What is it associated with?
Bacterial vaginosis (BV) is associated with higher-than-normal pH in the vagina that allows certain bacteria to become dominant.
Vaginosis:
What are conditions that raise the pH in the vagina?
Conditions that raise the pH include antibiotic use, contraception, pregnancy, intercourse, and tampons.
Vaginosis:
What are factors that predisposed a person to BV?
Factors that predispose people to BV include douching, removing pubic hair by shaving or waxing, smoking, and having multiple sexual partners.
Vaginosis:
What are signs and symptoms of BV?
Signs and symptoms of BV include fishy vaginal odor and thin white/gray vaginal discharge.
Vaginosis:
How does it resolve?
Often resolves spontaneously but may be treated with oral metronidazole or vaginal cream.
Vaginitis: What does this mean?
Vaginitis means inflammation of the mucosa of the vagina.
Vaginitis: What is a cause of this?
Candida vulvovaginitis (also known as yeast infection) is a common cause of vaginitis.
Vaginitis:
What is it associated with?
Associated with the use of some antibiotics, restrictive clothing, underwear made with artificial fibers, and glucose intolerance.
It may occasionally be shared sexually.
Vaginitis: What are symptoms?
Females may report a thick, cottage cheese-like vaginal discharge or acute vaginal dryness.
Examination findings include inflamed tissue of the vulva.
Vaginitis: How may it be treated?
May be treated with over-the-counter medications or fluconazole.
Vaginitis:
What should females with reccurrent yeast infections be assessed for?
Females with recurrent yeast infections should be assessed for diabetes.
Vaginitis: Trichomoniasis
What is it? What is it caused by?
Trichomoniasis is a sexually transmitted form of vaginitis caused by Trichomonas vaginalis.
What is the most common non viral STI?
Trichomoniasis is the most common nonviral STI.
Vaginitis: Trichomoniasis:
If left untreated, what can it lead to?
If untreated, trichomoniasis can lead to cystitis, cellulitis, infertility, preterm birth, premature rupture of membranes, and pelvic inflammatory disease (PID).
Vaginitis: Trichomoniasis:
What are signs and symptoms? How are some females?
Signs and symptoms include a thin vaginal discharge, fishy odor, vulvar irritation, pelvic pain, dysuria, urinary frequency, and off-schedule vaginal bleeding.
Some females, however, are asymptomatic.
Vaginitis: Trichomoniasis
How can it be treated?
Trichomoniasis may be treated with a single dose of metronidazole.
Vaginitis: Trichomoniasis
Who else must be treated?
Sexual partners must be treated as well to avoid reinfection.
Slide 8
What is the most commonly diagnosed bacterial STI in the US?
Chlamydia is the most commonly diagnosed bacterial STI in the United States.
Chlamydia:
How are symptoms of chlamydia usually?
Chlamydia is often asymptomatic.
Chlamydia:
How are symptoms in males?
However, males may experience urethritis, proctitis, or epididymitis while females may experience cervicitis, PID, perihepatitis (inflammation of the liver), or reactive arthritis.
Chlamydia:
What can chlamydia cause?
Chlamydia can cause infertility and ectopic pregnancy by causing inflammation of the fallopian tubes leading to scarring.
Chlamydia:
How is it diagnosed?
Diagnosed by urinalysis or vaginal, cervical, or urethral swab sampling.
Chlamydia:
What is treatment? Retesting? Other partners?
Treatment includes doxycycline or azithromycin (if rectal infection). Sexual partners should also be treated. Retesting should be done 3 months after treatment.
What is the second most prevalent STI in the US
Gonorrhea
Gonorrhea: What can it lead to?
Gonorrhea can lead to PID which may cause infertility, ectopic pregnancy, and pelvic pain.
Gonorrhea:
How are symptoms? What are they similar to?
Symptoms are similar to chlamydia: urethritis in males and cervicitis in females.
Gonorrhea:
How should screening be done? Why?
Because most people are symptomatic, routine screening is recommended.
Gonorrhea:
What is first line treatment?
First-line treatment is ceftriaxone or cephtriaxone (pharyngeal) although some strains are antibiotic resistant.
Syphilis:
How are rates of syphillis?
Rates of syphilis have been rising since 2000.
Syphilis:
How does syphilis occur?
Syphilis occurs in four stages:
Syphilis:
What are the four stages of syphilis?
primary, secondary, latent, and tertiary.
Syphilis: How are symptoms among individuals?
Symptoms often vary greatly among individuals.
Syphilis:
Four stages of syphilis: Primary syphilis?
Primary syphilis: May present as single, painless chancre, multiple or uncomfortable lesions.
Syphilis:
Four stages of syphilis: Secondary syphilis?
Secondary syphilis: Individual may have a rash.
Syphilis:
Four stages of syphilis: Latent (hidden) syphilis
Latent (hidden) syphilis: Asymptomatic period that may last for years.
Syphilis:
Four stages of syphilis: How is Latent (hidden) syphilis in pregnant people?
Pregnant people in latent syphilis can transmit syphilis to their fetus for the first 4 years of the latency period.
Syphilis:
Four stages of syphilis: Tertiary syphilis- what does it affect?
Tertiary syphilis: May affect multiple organ systems including brain, nerves, and joints.
Syphilis:
What is the treatment of choice?
Penicillin G is the treatment of choice.
Herpes Simplex Virus: How is it transmitted?
Herpes simplex virus (HSV1 and HSV2) is transmitted by skin-to-skin contact, usually of the mucosa.
Herpes Simplex Virus: How is the virus?
The virus is usually dormant and is not contagious.
Herpes Simplex Virus: When is a person contagious?
Just prior to, during, and after an outbreak, an individual is contagious.
Herpes Simplex Virus: How is primary herpes genital infections?
Primary herpes genital infections may be asymptomatic or may include a painful vesicular rash and skin erosions, fever, headache, and dysuria.
Herpes Simplex Virus: How is secondary herpes genital infections?
Secondary infections are typically less acute and more likely to be asymptomatic.
Herpes Simplex Virus: What is HSV1 most commonly associated with?
HSV1 is most commonly associated with cold sores.
Herpes Simplex Virus: What is HSV2 most commonly associated with?
HSV2 is most commonly associated with genital lesions; however, either virus can be present in any mucosa.
Herpes Simplex Virus: What is treatment?
Treatment includes medication (valacyclovir, acyclovir, and famciclovir) for HSV suppression not cure.
Hepatitis A: How is it transmitted?
Hepatitis A is transmitted via the fecal oral route and has an incubation period of 28 days.
Hepatitis A: What are risks for acquiring hepatitis A?
Risks for acquiring hepatitis A include illicit drug use, living in a residential facility, exposure to day care centers, and sexual activity between males.
Hepatitis A: How are symptoms?
Most are asymptomatic but some may report abdominal pain, flu-like symptoms, nausea, vomiting, anorexia, jaundice, and pruritis.
Hepatitis A: How does Hep A resolve? How long?
Generally self-limiting with full recovery for most patients within 2 to 3 months.
Hepatitis A: What is specific treatment for Hep A?
No specific treatment beyond supportive care.
Hepatitis A: How long has Hep A vaccination been routine?
Vaccination has been routine for all infants since 2006.
Hepatitis B: How are symptoms?
Hepatitis B may be asymptomatic or include right upper quadrant discomfort, nausea, vomiting, anorexia, jaundice, and fatigue.
Hepatitis B: What are primary modes of transmission of Hep B?
Primary modes of hepatitis B transmission are perinatally, unprotected sexual intercourse, and illicit IV drug use.
Hepatitis B: What are people with Hep B at risk for?
People with hepatitis B are at risk for cirrhosis, liver failure, liver cancer, and death.
Hepatitis B: What is the most effective means for avoiding Hepatitis B infection?
Vaccination is the most effective means of avoiding hepatitis B infection.
Hepatitis B: How is the Hepatitis B vaccination administered?
Vaccination is provided in 3 doses, with the second dose 1 month after the first and the third dose 6 months after the first.
Hepatitis B: When is it recommended to start the Hepatitis vaccinations?
It is recommended that the first dose of the hepatitis vaccine be started at birth.
Hepatitis C: What is it? What increases the risk of Hep C?
A bloodborne disease with a low risk of sexual transmission; however, risk is higher among heterosexuals with multiple partners and males who have sex with males.
Hepatitis C: What is the most common means of transmission in the US?
The most common means of transmission in the United States are IV drug use and vertical transmission from pregnant person to neonate.
What is the leading cause of liver cancer and liver transplant in the United States?
Hepatitis C
Hepatitis C
What are risks to developing Hep C?
Hepatitis C risks include cirrhosis of the liver, liver failure, and liver cancer.
Hepatitis C:
How are most patients with Hep C symptom-wise?
Most patients with hepatis C are asymptomatic or complain of nonspecific symptoms such as fatigue.
Hepatitis C:
What does treatment include?
Treatment includes antiviral therapy that is curative for 97% to 100% of patients.
Human Immunodeficiency Virus (HIV):
What are risks for becoming infected with HIV?
Risks for becoming infected with HIV include receiving contaminated blood products, IV drug use, and having unprotected intercourse.
Human Immunodeficiency Virus (HIV):
Stages of HIV include:
Acute infection:
Chronic HIV without acquired immunodeficiency syndrome (AIDS):
Human Immunodeficiency Virus (HIV):
Acute infection: When is it? What is it characterized by?
Acute infection: The first 6 months after acquisition is commonly characterized by flu-like symptoms, fever, headache, sore throat, rash, myalgia, and arthralgia.
Human Immunodeficiency Virus (HIV):
Chronic HIV without acquired immunodeficiency syndrome (AIDS):
When does it occur, how long does it last?
Chronic HIV without acquired immunodeficiency syndrome (AIDS):
Begins 6 months after infection and lasts until the cluster of differentiation 4 (CD4) count is below 200. In the absence of therapy, this often asymptomatic stage typically lasts a decade or less.
Human Immunodeficiency Virus (HIV):
Chronic HIV without acquired immunodeficiency syndrome (AIDS):
In the absence of therapy, how long does this stage last?
Begins 6 months after infection and lasts until the cluster of differentiation 4 (CD4) count is below 200.
In the absence of therapy, this often asymptomatic stage typically lasts a decade or less.
Acquired Immunodeficiency Syndrome (AIDS):
When does HIV become AIDS?
HIV becomes AIDS when the HIV virus causes the CD4 count to drop below 200 cells/mcL, or when the patient with HIV is diagnosed with an AIDS-defining condition.
Acquired Immunodeficiency Syndrome (AIDS):
HIV treatment has progressed over the years using what?
HIV treatment has progressed over the years using antiretroviral therapy (ART).
Acquired Immunodeficiency Syndrome (AIDS):
What does ART do?
ART reduces mortality, progression of HIV to AIDS, and AIDs-defining diagnoses.
Acquired Immunodeficiency Syndrome:
Acquired AIDS defining illnesses include:
Candidiasis of the esophagus, bronchi, trachea, or lungs
Invasive cervical cancer
Cytomegalovirus disease
Encephalopathy, related to HIV
Kaposi sarcoma
Several forms of lymphoma
Recurrent pneumonia
Recurrent mycobacterium infections
Recurrent Salmonella septicemia
Toxoplasmosis of the brain
Wasting syndrome due to HIV
